Oral implant stabilizer and denture support

ABSTRACT

Apparatus for adjustably stabilizing dental implant blades and forming a meso-structure on which a superstructure or denture is mounted in a manner that the denture is not directly supported by the gingival tissue of a patient&#39;&#39;s jaw.

United stateS Patent 1 91 Thibert July 31, 1973 [54] ORAL IMPLANTSTABILIZER AND 2,599,044 6/1952 Brennan 32/2 DENTURE SUPPORT [76]Inventor: John N. Thibert, 264 Beacon St., primary Examiner-Robenpeshock Boston, Mass- 021 16 AttorneyA. Yates Dowell, Jr.

[22] Filed: Oct. 4, 1971 [21] A 1. No.: 186 132 pp 57 ABSTRACT [52] U.S.Cl 32/10 A Apparatus f adjustably Stabilizing dental implant [5 l Cl. Hblades and foming a meso structure on a uper- Fleld of Search A, 2, 8tructure or denture is mounted in a manner the denture is not directlysupported by the gingival tissue [56] References Cited f a patients jaw.

UNITED'STATES PATENTS 6/1970 Silverman 32 10 A 8 Claims, 16 DrawingFigures PATENTEUJULBHSB 3.748'739 MU 1 BF 3 INVENTOR J07!" M 77 ibertPAIENIEU 3.748.739

sum 2 or 3 IN VENTOR John M 771 ibert ATTORNEYS PAIENIED 3.748.739

sum 3 or 3 INVENTOR John M T/Liber't ATTORNE 4,0170% fdjufi'mg ORALIMPLANT STABILIZER AND DENTURE SUPPORT BACKGROUND OF-THE INVENTION 1.Field of the Invention This invention relates generally to dentistry andthe application of denturesto a humans mouth and relates particularly tooral implantology and the stabilizing of implantblades as well asproviding a support for dentures.

2. Description of the Prior Art For many years the loss of permanentteeth by a person resulted in the need of a denture to replace the natural teeth to assist a person to chew as well as to insure the properfunctioning of the remaining natural teeth. In these prior artstructures, the denture has rested on the gingival tissue and wherepossible has been anchored to existing natural teeth to maintain thedenture in position. In cases where all ofthe teeth have been extractedfrom either the upper or lower jaw or both, a full denture has beenapplied directly to the gingival tissue as soon as the natural teethwere extracted or at some later date, depending upon the skill'anddesire of the individual dentist.

Although this was the only course available at the time, it was notsatisfactory and success depended upon many variables including thepatients perseverance and ability to tolerate the discomfort as well asthe greatly diminshed chewing capability. Also, since the denture wasmerely resting on the gingival tissue, the alveolar bone resorbedcausing shrinkage of the tissue, which inturn made it necessary toreline or rebase the denture to provide a proper fit.

When a patient could not or would not wear his denture, any remainingnatural teeth would tend to drift and any opposing teeth in the oppositejaw would tend to loosen and become elongated due to lack of resistance.Also if a patient still had natural teeth on one side of his jaw, he didsubstantially all of his chewing on that side and this caused a strainon the temporomandibular joint on the other side which was edentulousand eventually caused substantial pain.

In recent years major advances have been made in the field of dentistryby providing endosseous and subperiosteal implants having clampingfingers or a penetrating blade in which the gingival tissue has beenlaid open by surgery and the implant has been clamped to or imbedded inthe alveolar and cortical bone structure of the patients jaws. Theseimplants include a head which extends upwardly from the fingers or bladefor a distance sufficient that the head extends above the gingivaltissue when the tissue is sutured in its normal position. Thereafter ameso-structure or bar has been cemented or otherwise attached to theheads and used to support a superstructure or denture. Examples of thistype of device are the patents to Brennan U.S. Pat. No. 2,644,231;Linkow et al. U.S. Pat. No. 3,499,222; Silverman U.S. Pat. No.3,514,858; and the Italian U.S. Pat. No. 526,441.

These prior art devices have not been entirely satisfactory since thecritical period for maintaining the implant in fixed position isimmediately after the implant is inserted; however, the bar ormeso-structure which is applied to the implant must be formed after theimplant is in position which necessarily indicates a delay in theapplication of the bar to the implant blade heads. Some efforts havebeen made to stabilize the implant blades during this critical period;however, these structures have been on a temporary basis and have notalways satisfactorily performed the function for which they wereintended. Also in these prior art structures the dentist is required tospend considerable time and effort with the patient and it is necessarythat the dentist not only insert the implants, but also substantiallytake over the care of the patient and form the support bar as well asthe subsequent denture which is applied thereto. This has causedsubstantial apprehension in some patients, particularly since their owndentist with whom they are familiar is not involved in the operation.

SUMMARY OF THE INVENTION The present invention is an oral implantstabilizer and denture support having portions connected to implantblades and including adjustable structure which is applied at the timeof the implant operation. The stabilizer is fixed in adjustedposition'in such a manner that the patients general practitioner canform the superstructure or denture at his convenience, and in whichsubsequent dentures can be formed by the general practitioner. Thepresent concept and technique are a radical departure from knownprocedures in that the dentist inserting the implants and the adjustablestabilizer structure allows the general practitioner to complete thecase. This obviously reduces the timerequired by the dentist who is aspecialist and therefore reduces the inherent cost to the patient. Thepresent structure has many advantages over existing structures andtechniques including:

1. The immediate stabilization of all implant blades which substantiallyprevents movement of the blades and thereby promotes bone regenerationand reduces failures. 2. It supports a superstructure or denture whichis not tissue borne and thereby eliminates impingement and irritation tothe gingival tissue.

2. It supports a superstructure or denture which is not tissue borne andthereby eliminates impingement and irritation to the gingival tissue.

3. It minimizes the stress on the tissue and bone of the opposing jawthereby preventing bone resorption.

4. It reduces strain on the temporomandibular joint and thereforeconforms to the requirements established by gnathologists.

5. It prevents the start of periodontal problems due to the lack ofirritation to the tissues and encourages the maintaining of good dentalhygiene.

6. It permits the general practitioner and his Laboratory technician toprepare the superstructure or denture without difficulty or error bysimple impression techniques.

7. There is no loss of alveolar bone since the foundation of the implantblade is attached to the bone in a manner similar to natural tooth rootsand therefore the bone regenerates as the denture is used.

8. The meso-structure has the versatility of working in combination withendosseous and subperiosteal implants, as well as with natural teeth.

9. The meso-structure can be removed at any time desired without injuryto the soft tissue or bone.

10. Dummy transfer pins are provided which are set in a permanent modeland can be used at any time to form a denture and such denture will fitthe individual patient without alteration.

It is an object of the invention to provide an oral implant stabilizerand denture support for use with an implant blade which will immediatelystabilize the implant blade and provide the sole support for a dentureso that t the denture does not engage the gingival tissue.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective illustrating ajaw with a denture in place.

FIG. 2 is an exploded perspective thereof illustating one application ofthe invention.

FIG. 3 is an enlarged section on the line 33 of FIG. 1.

FIG. 4 is an enlarged section on the line 44 of FIG. 1.

FIG. 5 is a fragmenatary top plan view of the mesostructure of thepresent invention.

FIG. 6 is a section on the line 66 of FIG. 5.

FIG. 7 is an enarged fragmentary section on the line 7-7 of FIG. 6.

FIG. 8 is an enlarged section on the line 8-8 of FIG. 6 and illustratingone of the transfer pins.

FIG. 9 is a side elevation of a dummy transfer pin.

FIG. 10 is a bottom perspective of a mounting cap.

FIG. 11 is a top plan view illustrating the first step in preparing adenture.

FIG. 12 is an enlarged section on the line 12-12 of FIG. 1 l andillustrates the removal of the dummy transfer pins from themeso-structure.

FIG. 13 is an enlarged section similar to FIG. 12 of i DESCRIPTION OFTHE PREFERRED EMBODIMENTS With continued reference to the drawings, animplant member 20 is provided which is inserted in the alveolar bone 21of a dental patient. The implant member includes an upwardly extendingpost 22 with a substantially spherical head 23 at the outer end thereof.After the member 20 is implanted, gingival tissue 24 is sutured over themember and around the post 22 with the head 23 located above suchtissue. In the absence of any natural teeth, at least three implantmembers are attached to the alveolar bone and normally at least four ofsuch members are used to form a firm foundation for a meso-structure 25and a superstructure or denture, as

well as to distribute chewing pressures along the length structureincludes a pair of posterior copings 28 connected to the two rearmostmembers and a pair of anterior copings 29 connected to the two forwardimplant members. Both the posterior and anterior copings 28 and 29include a generally cylindrical body 30 having a substantially sphericalcavity 31in one end in which the spherical'head 23 of the implant memberis.re--

ceived. Preferably the lower wallsof the copings are crimped to the head23 topreventseparation-of the copings from the implant members. The body30 of each of the copings 28 and 29 is rotatably mounted on' thespherical head 23 and a set screw 32 is provided in each of the bodiesfor fixing the body 30 in adjusted position relative to the head 23.Each of the bodies 30 in cludes a dovetail 33 extending generallyaxially of the ings, a pair of connecting links or rods 34 and 35 areprovided with one of the links having a bifurcated end 36 and the otherlink having a tongue 37 forming a close sliding fit with thebifurcatedend 36. The upper portion of the bifurcated end is providedwith a smooth opening 38 and the lower portion is provided with athreaded opening 39 with the axis thereof generally in alignment withthe axis of the opening38 and normal to the axis of the associated link.The tongue 37 is provided with an opening 40 adapted to be disposed inaxial alignment with the openings 38 and 39 for the reception of atransfer pin 41. Such tranfer pin includes a shank 42 having a sphericalhead 43 at one end and a reduced threaded portion 44 at the oppositeend. The shank 42 extends through the openings 38 and 40 and the reducedportion 44 is threaded into the opening 39 so that the transfer pin willfunction as a hinge for the connecting links 34 and 35. As-illustratedin FIGS. 6

and 8, the head 43 of each of the transferpins 41 is spaced above theconnecting links.

At the opposite end of each of the links 34 and 35,

ceived within a threaded bore 50 ofa slide member 511 having a dovetailgroove 52 along one side. The turn buckle 48 has right and left-handthreads at opposite ends so that the links and slide members are movedtoward each other when the turnbuckle is rotated in one.

direction, and moved away from each other when the turnbuckle is rotatedin the opposite direction.

The slide member 51 has a set screw 53 in the area adjacent to thedovetail groove so that when the groove 52 slidably engages the dovetail33 of the posterior and anterior copings, the slide members 51 of theconnecting links 34 and 35 can be adjusted vertically and fixed inadjusted position by the set screws 53. As illustrated in FIGS. 5 and 6,the turnbuckle 48 is adapted to be secured in fixed position by a setscrew 54 carried by the links 34 and 35. I

In order to prevent foreign material, such as particles of food and thelike, from becoming lodged in the area of the turnbuckle, a reducedthreaded portion 55 is provided on each of the slide members 51 and suchreduced portion threadedly engages one end of a tapered sleeve or cover56. The opposite, end of the sleeve-56 has a bore 57 which slidably androtatably receives the connecting links.

As illustrated best in FIG. 5, the anterior copings 29 are provided witha sliding block 60 having an arcuate.

recess of a size to slidably engage the body 30 and with the walls ofthe sliding block extending around over one-half the diameter of thebody of the anterior coping. The sliding block 60 has one or more setscrews 62 for securing the sliding block 60 in fixed position on theanterior coping 29. The anterior copings 29 on opposite sides of thebody are connected to each other by a pair of arcuate connecting links63 and 64. Such links are connected to the sliding blocks 60 by turnbuckle's 48 and are connected to each other by a hinge-forming transferpin 41 as previously described. Due to the relatively sharp curvature ofthe front of the jaw bone 21, as well as varying configurations of suchbone, it is contemplated that several connecting links 63 and 64 ofvarious lengths can be provided to accommodate substantially all bonestructures. Also it is contemplated that the links 63 and 64 may bereplaced by a single arcuate connecting member (not shown) which isconnected in any. desired manner to the anterior copings 29.

A denture or superstructure 65 is adapted to be supported by thetransfer pins 41' of the meso-structure 17. As illustrated in FIGS. 3and 4, the denture includes a set of artificial teeth 66 integrallyformed with artificial gums 67. The distal ends of the gums 67 arespaced slightly from the gingival tissue 24 so that there issubstantially no contact which could cause irritation.

In order to mount the denture 65 on the mesostructure, a plurality ofTshaped caps 68 are provided (FIG. and such caps include an upper crossmember 69 fixed to one end of a generally cylindrical body 70. The bodyis constructed of resilient material and has a spherical recess 71 inthe end remote from the crossmember 69. The recess 71 is substantiallythe same size as the spherical head 43 of the transfer pins 41 and suchrecess extends around slightly more than one-half the diameter of thespherical heads 43. A slot 72 is provided in the body 70 in the area ofthe recess 71 to permit the resilient body 70 to spread slightly andclampingly engage the spherical head 43 of the transfer pins 41. Thecrossmembers 69 are imbedded within the artificial gums 67 so that thecaps 68 remain in fixed position relative to the denture 65.

With reference to FIG. 16, a modified form of the invention is disclosedin which at least one natural tooth remains in the patients mouth andsuch tooth is utilized as an anchor for the meso-structure. In thismodification the natural tooth preferably is ground down and a generallytubular coping 73 is applied over the stump of the tooth and is attachedthereto by a set screw'74. The tubular coping 73 is provided with atleast one dovetail (not shown) similar to the copings 28 and 29 andadapted to receive at least one sliding member 51 as previouslydescribed. In the event that the natural tooth should be lost at a laterdate, an implant member 20 could be substituted for the tooth and themeso-structure-could be adjusted to the new implant.

The technique involved in the fitting of the mesostructure, as well asthe preparation of the denture, is as follows:

A patient and his local practitioner visit a specialist in oralimplantology and after extensive mental and physical examinations of thepatient have been completed; the implant members 20 with the posteriorand anterior copings 29 attached thereto are surgically applied to thealveolar and cortical bone 21 of the patient and the gingival tissue 24is closed by suturing. Thereafter the meso-structure 27 is assembled andadjusted in such a manner that the connecting links 34 and and the links63 and 64 do not engage the tissue 24 of the patient. The meso-structurestabilizes the implant members and the bone immediately begins toregenerate to firmly anchor the implant member. The local practitioneris carefully instructed as to the structure and use of themeso-structure, as well as the proper techniques for-forming the denture65. A temporary splint (not shown) is applied to the meso-structureafter which the local practitionerand the patient return home. I

After a short period of time, the transfer pins 41 are removed from themeso-structure and are replaced by dummy transfer pins 75 each of whichhas a shank 76 with a spherical head 77 at one end and a reduced portion78 at the opposite end. The shank 76 and the, spherical head 77 aresubstantially identical with the shank 42 and spherical head 43 and thereduced portion 78 is of a size to be slidably received within thethreaded opening 39.

When the dummy transfer pins 75 are in position, a rubber sheet or dam79 having openings 80 located in a position to be received over thedummy transfer pins 75 is applied to the patients mouth. The T-shapedcaps 68 are placed on the spherical heads 77 of the dummy transfer pins75 after which a mass 81 of quick-setting material such as wax or thelike (FIGS. 12 and 13) is applied to the dam 79 in such a manner thatthe caps 68 are imbedded within the mass. When the mass has set, it isremoved from the patients mouth and such removal pulls the dummytransfer pins 75 from the mesostructure 27 and the transfer pins 41 arereapplied thereto.

The mass 81 with the caps 68 and the dummy transfer pins 75 forms afemale mold into which a moldable material such as artificial stone ispoured. The dummy transfer pins 75 which were projecting outwardly ofthe mass 81 are imbedded within the artificial stone so that when thestone has set the dummy transfer pins will be fixed in the exactlocation of the transfer pins 41. Thereafter the mass 81 is melted orbroken to recover the T-shaped caps 68 and leaves a stone impression ofthe patients mouth with portions of the dummy transfer pins 75 fixedtherein.

The caps 68 again are applied to the dummy transfer pins which are nowin the stone impression and the denture 65 is molded about theimpression in such a manner that the caps are imbedded within thedenture. When the denture has cured, it is removed from the stoneimpression by separating the caps 68 from the dummy transfer pins andthereafter the denture can be applied to the transfer pins 41 within thepatients mouth with substantially no alterations since the denture doesnot engage the gingival tissue 24 of the patient and the caps 68 shouldbe in exact alignment with the transfer pins 41. A slight force appliedtothe denture will cause the caps 68 to snap onto the spherical heads 43of the transfer pins where they will remain until the denture isremoved.

The local practitioner normally preserves the stone impression with thedummy tranfer pins mounted therein so that in the event of loss ordamage to the denture 65, a new denture canbe formed without thenecessity of another impression being taken or without the patientsbeing present.

I claim:

1. An adjustable support structure for use in stabilizing an oralimplant and for removably supporting a denture, said support structurecomprising a plurality of spaced post means, means for attaching saidpost means to the implant or to an existing tooth of a patient, linkmeans adjustably fixed to at least two of said post means forstabilizing said post means, at least one denture receiving pin carriedby said link means, and 'rneans for removably connecting the denture tosaid 2. The structure of claim 1 in which said link means is adjustableaxially of said post means so that said link means is in spaced relationto the gingival tissue of the patient.

3. The structure of claim 1 in which said link means includes a pair oflinks hingedly connected together by said pin.

4. The structure of claim 1 in which said link means includes a slidemember adjustably mounted on each of said post means.

5. The structure of claim 1 in which said means for removably connectingthe denture to said pin includes a cap having a first portion imbeddedwithin the denture and a second portion for clampingly engaging said 8pin.

6. The structure of claim 1 in which said link means is adjustablyconnected to each of said post means by turnbuckles. t

7. The structure of claim 6 including sleeve means slidably mounted onsaid link means for covering said tumbuckles.

8. An adjustable support structure for use in stabilizing an oralimplant and for removably supporting a denture, said support structurecomprising a plurality of generally cylindrical post members havingsubstantially vertical axes, means for attaching said post members tothe implant orto an existing tooth of a patient, at least one slidemember slidably mounted on each of said post members, a pair oflongitudinally adjustable link means, each of said link means beingconnected at one end to one of said slide members and the opposite endsof said link means being hingedly connected together by a pin, said pinhaving a head, cap means clampingly engaging said pin head, and said capmeans having portions imbedded within the denture, whereby the dentureis supported by said pin and said pin is supported by said link meansand said post members.

k IF

1. An adjustable support structure for use in stabilizing an oralimplant and for removably supporting a denture, said support structurecomprising a plurality of spaced post means, means for attaching saidpost means to the implant or to an existing tooth of a patient, linkmeans adjustably fixed to at least two of said post means forstabilizing said post means, at least one denture receiving pin carriedby said link means, and means for removably connecting the denture tosaid pin.
 2. The structure of claim 1 in which said link means isadjustable axially of said post means so that said link means is inspaced relation to the gingival tissue of the patient.
 3. The structureof claim 1 in which said link means includes a pair of links hingedlyconnected together by said pin.
 4. The structure of claim 1 in whichsaid link means includes a slide member adjustably mounted on each ofsaid post means.
 5. The structure of claim 1 in which said means forremovably connecting the denture to said pin includes a cap having afirst portion imbedded within the denture and a second portion forclampingly engaging said pin.
 6. The structure of claim 1 in which saidlink means is adjustably connected to each of said post means byturnbuckles.
 7. The structure of claim 6 including sleeve means slidablymounted on said link means for covering said turnbuckles.
 8. Anadjustable support structure for use in stabilizing an oral implant andfor removably supporting a denture, said support structure comprising aplurality of generally cylindrical post members having substantiallyvertical axes, means for attaching said post members to the implant orto an existing tooth of a patient, at least one slide member slidablymounted on each of said post members, a pair of longitudinallyadjustable link means, each of said link means being connected at oneend to one of said slide members and the opposite ends of said linkmeans being hingedly connected together by a pin, said pin having ahead, cap means clampingly engaging said pin head, and said cap meanshaving portions imbedded within the denture, whereby the denture issupported by said pin and said pin is supported by said link means andsaid post members.